by Devon Green, VP of Government Relations It’s Town Meeting Week, when the legislators are released from the State House and allowed back in the wild to take a breather and catch up with their constituents. If you have thoughts about bills or issues, now is a good time to catch them. You’ll likely spot them at your local town meeting or the polls—all the more reason to get out there and vote!
Prior Authorization and Claims Edits: A huge thank you to the House Health Care Committee for unanimously supporting H.766, a bill that reduces administrative burden for providers and patients with the following:
- Aligns commercial insurance prior authorizations to Medicaid, with the exception of prescription drugs.
- This is big. Simplifying prior authorizations through alignment has the potential to retain current providers suffering from burnout and attract new providers who are looking to reduce their administrative burden.
- Requires a response to urgent prior authorization requests within 24 hours.
- No renewal requirement for the course of treatment or one year, whichever is longer and no frequent than every five years for long-term treatments.
- Aligns outpatient, professional services, and facility claims to Medicare.
The bill goes to the House floor next week. If you’d like to contact your local representative in support of the bill, you can find contact information here.
Health Care Reform and Regulation: The Senate Health and Welfare Committee heard from witnesses on S.151, an omnibus bill that also addresses hospital global budgets and regulation.
VAHHS testified that it was important to add intent language to the bill as a way to signal to the federal government the need for additional funding and to signal to hospitals that there will be a process between the Green Mountain Care Board and the Agency of Human Services for developing a regulatory framework for global budgets.
For the current hospital budget process, VAHHS proposes that the Board maintain its current practice around benchmark-setting and not change benchmarks after budget guidance is in place.
VAHHS also proposes that the Board uses the same principles for hospitals as it uses for insurers when looking at budgets. For VAHHS positions on each section, go here.
The Green Mountain Care Board expressed concern around any provisions in the bill that may weaken its authority. There is disagreement amongst multiple parties on this bill.
Workforce: Both health care committees took up workforce issues last week.
- International Medical School Graduates: Chris Dougherty, CEO of Brattleboro Memorial Hospital, testified in support of a working group to issue temporary medical licenses to individuals who completed international residencies along with any other opportunities to streamline licensure for international health care providers. The Board of Medical Practice testified that Vermont already has strong pathways for international medical school graduates.
- Workforce Development Efforts Review: The House Health Care Committee heard reports of current health care workforce efforts. Jerry Bakke, Network Director, Workforce Development at the UVM Health Network testified on extending the LPN nursing pipeline program and continue the Vermont State University Respiratory Therapy Program, amongst many other efforts. The Vermont Student Assistance Corporation (VSAC) also testified on changes that would improve the Nursing Forgivable Loan program. The Committee will consider working on a bill to improve current programs next week.
Psilocybin: The Senate Health and Welfare Committee took up S.114, a bill that establishes a Psychedelic Therapy Advisory Working Group to examine the use of psychedelics on physical and mental health. Kurt White, the Brattleboro Retreat’s Vice President of Outpatient Programs and Community Initiatives testified that psilocybin holds real promise for some of the most complex mental health conditions. The committee will return to the bill next week.
Vermont Association of Hospitals & Health Systems
